Patient Instructions For Before and Aftercare
Please follow the instructions for your treatment for best results.


Before & After Care for Cosmetic Dermal Fillers
What To Do & What To Avoid Before Your Filler Treatment
In order to reduce the amount of bruising and/or swelling from the injection sites, please follow the instructions below.
- Avoid blood thinning over-the-counter medications such as Aspirin, Motrin, Ibuprofen, and Aleve for 1 week prior.Please consult your physician if you are taking Aspirin for medical reasons!
- Avoid supplements, including St. John’s Wort, gingko biloba, primrose oil, garlic, ginseng, and Vitamin E for 1 week. You may use Arnica Montana tablets and eat pineapple beginning 3 – 5 days prior to your appointment. Arnica and the bromelain in pineapple can help minimize bruising and inflammation.
- Avoid topical products such as Tretinoin (Retin-A) and Retinols for 3 days prior to treatment.
- Avoid waxing, bleaching, tweezing, or hair removal cream on the area to be treated for 3 days prior.
- Do not drink alcoholic beverages for 24 hours prior to treatment.
- If you are prone to cold sores, there is a risk that the needle punctures could contribute to an outbreak. Please let the nurse or physician know if you are prone to cold sores.
- Do not use dermal fillers if you are pregnant or breastfeeding, are allergic to any ingredients, including lidocaine, or suffer from neurological disorders. Please inform us if you have any questions about this prior to your treatment.
Day of Treatment
- Arrive to the office with a “clean face” – washed and without makeup.
- In order to maximize your comfort during the procedure, a topical anesthetic may be applied. In some cases, a local numbing medication will be injected into or around the area(s) to be treated.
Within the First Hour After Treatment
- Immediately after the treatment, there may be redness, bruising, swelling, tenderness, and/or itching near the injection site. Avoid itching, massaging, or picking around the injection site. This is normal and generally disappears within a few hours to a few days. If these symptoms last more than 3 days, please contact our office.
- Some suggestions that may be helpful: ice, arnica cream and tablets, and bromelain tablets – all of which can reduce or resolve potential bruising
- You may take acetaminophen (Tylenol) to reduce any pain as necessary
Within 6 to 10 Hours After Treatment
- Avoid drinking alcohol or partaking in strenuous exercise, as it may result in additional bruising.
- Until the swelling and redness have resolved, avoid intense heat in the treated area(s). This includes sunbathing, tanning, saunas, hot tubs, or hot wax. Also avoid extreme cold such as skiing or other winter sports.
- To help alleviate bruising, we recommend using Tylenol rather than aspirin or ibuprofen during the first 24 hours. After 8 hours, you may apply topical Arnica – a natural ointment commonly used to reduce bruising. You can find this in the natural foods section of your grocery store or at local pharmacies. We will also be glad to apply LED lights by appointment and for a nominal charge.
- Minimize movement of the treated area(s). However, if there is a visible bump, you can massage the area. Depending on the areas treated and the product used, you may feel “firmness”. These areas will soften and settle with time (usually 1-2 weeks)
- To avoid introducing bacteria into the skin, you should wait 12 – 24 hours before applying any makeup or other products to your skin. After that time, sunscreen and makeup can be applied and the area can be gently washed with a gentle cleanser. We recommend ZO or Obagi Gentle Cleansers or a sensitive cleanser such as Cetaphil to avoid additional skin irritation.
**Please Contact Us Immediately if You Experience**
- Fever and/or chills
- If the area appears red, hot to the touch, and “angry” looking.
- Severe pain or increasing pain
- Discolored blotches in areas not injected or blanching of injected areas
Any of these issues can be a symptom of a serious complication. Early diagnosis and treatment are imperative to avoid long-term complications. During business hours, please call the office at 919-904-7111. After hours, you can reach the Clinical Director by calling 919-656-8204.
Additional Post Treatment Recommendations
- For most patients, the benefits of dermal fillers can be enhanced by using a medical-grade skincare system, such as ZO Skin Health by Dr. Obagi. Products containing Vitamin-C can strengthen the skin and improve laxity and texture. The use of Tretinoin (or Retin-A) helps rebuild cells in the skin’s epidermis (or top layer). Over time, Tretinoin can strengthen skin, improving firmness and resiliency. Tretinoin (Retin-A) is available for purchase in our office – or through a prescription. Ask Dr. Berger or one of the nurses about the best concentration for your skin.
- 98% of skin damage (aging, wrinkles, dark spots, and hyperpigmentation) is caused by sun damage. Wearing sunscreen is critical to maintaining the look and health of your skin. Sunscreen should be re-applied every 4 hours during sun exposure. We recommend a sunscreen with an SPF of 45 or greater.
- If it is difficult for you to reapply sunscreen throughout the day, consider adding a powdered sunscreen (we recommend Colorscience) to your daily routine. These can be brushed on to the face and chest periodically. Another good option is a tinted SPF product, such as Revision Intellishade or Elta MD Clear Tinted.
How Long Will Dermal Fillers Last?
The short answer is, of course, it depends – what areas were treated and with which specific product. Cosmetic fillers are long lasting, but not permanent.
Some shorter term fillers made of hyaluronic acid, like Juvederm and Restylane, will last anywhere from 6-18 months* depending on the specific filler used, areas that were treated, and your body’s metabolism.
Most patients choose to have a follow up treatment 6-12 months after initial treatment for wrinkles. For lip injections or lip enhancements, we recommend a follow up visit after about 6-9 months.
*Patient results may vary
Call (919) 904-7111 With Questions About What To Do Before Or After Your Procedure